Any tips for self-maintenance after therapy?

Thank you. This has been so helpful. You're absolutely right. I got myself up early this morning even though I went to bed late and I did  a good bit of stuff I wanted to get done but I've been avoiding the one thing and that's probably what's bugging me because I haven't done it for days. About the list you're right! I used to write lists and try to get everything done and even if I had relaxing stuff on it, it felt like a chore because I couldn't get the list done. I had quite a long list written out a couple of days ago and I had put in priorities but I think you were right about not making it too long! I was choosing other smaller tasks because they seemed easier and avoiding the main one I wanted to do which must have been  bugging me! 

Also, I have actually been running recently on and off. Just where I'm from as it's not so easy for me to get somewhere else but I love the scenery and I actually do like looking at trees/flowers along the way etc. And I do like it because even though it's not so easy when I'm doing it, sometimes I think "I'd love to go for a run" so I must do!! 

The thing about the eating. . . well, it wasn't that I didn't feel hungry. It was that I would but I would ignore it. That's kind of a separate thing but I'm working on it too. You're probably right about not working to target one part of your body. I recognise that it should be about fitness, health and wellbeing rather than looks. I'm trying to work on that but I guess I have to get to a place where my self esteem  is higher before that'll become easier. 

Now all that said, I'm off to get something to eat and then to do that "big" task!! 

Thanks for the understanding and motivation! I wish you a very good day/week/life  

. . . And done! Wasn't that hard at all once I started because me being the organised person I am, I had most of it done before and I forgot and thought it would all be a mess to organise from scratch but it only took a few minutes. .. The same goes to you Jaguar! I'm so glad I came on this forum, I knew it would help to talk to people who may have been through the same kind of issues. Talking to someone who hasn't/hasn't been in contact with it always has its limits as they don't understand and sometimes that's all you need! 

Thanks Eric, you are right about switching lenses. Sometimes I just get quite down so I can find that very hard to do! But you are right "when you stop walking, talking and breathing then worry". . . :D 

anonymousgirl

Detra, this is awesome! I especially like number 2! Number 1 is really hard, even though I know it's true and number 4 is so empowering. . .I'll be copying and pasting some of this as that's what I would call a "golden list"! haha. . .No seriously though, thank you. 

PS Hey look I made a joke!!

PPS Thanks for the tip about the carbs, I never tried that before, even though to be honest I eat a lot of fruit and veg too. Maybe I'll try eating more protein though! :D And the caffeine, that'll be tough but I'll try it as you say you have to be active, ignoring the problem even though you know the cause and then complaining when it bothers you isn't going to do anything!! You have to fight the fear (or laziness as the case may be sometimes! . . .With me anyways, not saying it about anyone else!)!! 

No problem. I discovered the carb thing by accident. One day I just went without eating bread and ate like baked chicken poatoes,cheese bacon and egg omlet no toast and some cheese cubes and things like that but no crackers and found that I felt really good and could concentrate really well. In the past I can recall feeling this way and not really understanding why. The reason why this feeling was so noticable is because I felt like a fullness, a calmness, almost like a good kind of numbness like a soothing feeling in my emotions that had me feeling incredibly balanced and content and I had no racing thoughts and felt rational. When I have felt that feeling in the past it wasn't anything really great going on in my life that I could pin it too. But when I felt this same feeling after eating what I ate I'm thinking it's probably what I ate. I honestly think my body behaves strangely with white bread. And as soon as I drank coffee the good feeling went away and I had racing thoughts and emotions again. That's why I say stay off coffee if you can. Or just do white bread and coffee not all the time that way you can truly see the difference. If your body reacts the same it's really pretty remarkable to see the difference. As far as facing your fears being the hardest thing to do I would advise reading a book called Feel Good Mood Therapy by David Burns. You can buy it at Amazon. I have it on my kindle app.  There's a chapter that really helped me. It was a chapter called The Cause. Which it explains the causes of why we think/feel the way we do as to break down patterns of bad behaviors which in turn makes us feel and behave the way we do. It tells us the things we can't do without.Some people for example have to been in relationships no matter how abusive or bad just so they can't be alone because they don't understand they don't need other people to feel loved and some people have to have other people's approval and please them. There were other things that were were controlling people mentioned. My issue was me trying to get approval from others. As a result I didn't want to make people feel uncomfortable by confronting them when they did something I didn't like so I avoided confrontation, and even if I didn't like someone I grinned and bared it to spare their feelings instead of taking my feelings to account and setting boundaries for that encounter or relationship. What got to me was in the book the author was like are you going to die because someone doesn't approve of you? That's when I realized ok I can do this cause of course no I wouldn't die. But the most important thing I got from that is a sense of real empowerment. I think my desire for approval was undermining my mission in life and what I was trying to do. It made me more fearful as a result. So the moment I understood that I enacted it. I tell people how I feel as to make myself feel comfortable. I don't run and hide when there is something uncomfortable I don't want to deal with. I just face it. This is why confronting your fears is so important.

Unfortunately,I have never drank coffee. And I've been off white bread for  .. . I can't remember how long. At least a couple of months. .. so maybe it's not that so much. Although come to think of it, I was only eating brown bread in the mornings and switched to Cheerios/Special K recently enough. . . so that could be having an effect. I find I get hungry a couple of hours after Cheerios/Special K. But same with brown bread too. I think I just don't eat enough at breakfast to last me 'till lunch. But also, I like the idea of regular small portions instead of full meals because that's also a way of letting go of the fear of overeating :D Works for me anyways. 

I also bought the David Burns book a couple of months ago. I started it but never finished. This goes back to what Jaguar said about knowing what you have to do and doing it and I guess also about what you said about facing your fear. 

"My issue was me trying to get approval from others. As a result I didn't want to make people feel uncomfortable by confronting them when they did something I didn't like so I avoided confrontation, and even if I didn't like someone I grinned and bared it to spare their feelings instead of taking my feelings to account and setting boundaries for that encounter or relationship. " . . .Ditto!! To the point where I'd lose sleep over something because I'd just be worried about telling a friend how I really felt about something. Like a whole night's sleep. Over a little thing that other people wouldn't even really think about .. . I might read that book chapter! Thanks again! :D 

Thanks so much Christine. I'm actually on citalopram 20mg/day. And I did tell my doctor about the eating thing that cropped up recently. And that I remembered having the same kind of behaviour before years ago (I specified to him as well "back in 2007" ). So he knows that it was recurring I guess. I guess I was focusing on the fact that I didn't tell him the new details I remembered but on reflection, he had enough to get the picture and it wouldn't have really added anything to all the different elements of what I had to tell him. He knows about even the worst stuff that happened more recently too so I was honest with him. 

You are right though, he warned me that this might crop up again even though the last time I saw him I was feeling much better as I had just finished 6 weeks' therapy. He advised from the start that the drugs alone will not fix it and that they should be alongside therapy. He also advised that it may recurr and that it was a good idea to stay on the medication despite being finished therapy so I am on them with a repeat prescription for the moment. I have only forgotten it for one day and I have been on them for 2 and a half months. I was also on Nortem at the start. I didn't finish all ten so I have 2 and a half left. (I took a half the last time more recently) in case I need them. I guess I was just getting used to being off college and having far more spare time than I know what to do with. But I do intend on not going ahead with the attitude that everything is alright. I have the chance now to continue to work on things and I want to do that. I know I used to be more confident/happy/assertive before and I miss that girl I used to be but I guess I need to tell myself that she's not gone. I am her. I am me. That sounded a bit funny. But sometimes I suppose we need to say those things aloud to make them count and feel real. I am me. It doesn't matter if I haven't fully figured out who exactly that is yet or what I want to be. I am me. Every moment. And for now, that's all that matters. I'm alive and I'm me. . . .Ok, I'm getting repetitive now!

Thanks Christine! xx  

Sounds like you have a decent Doc who you feel comfortable opening up to - thats worth its weight in gold, so wel done on that...

Its always worth remembering that often it takes a few tries of different meds before you find one that really suits you - everyones different  and needs different doses etc... I would say you are still getting quite  a lot of anxiety and mental 'chatter' - thoughts going round and round and ruminating and pondering on stuff all the time that you find it hard to switch off? And to me that feels as tho maybe the citalopram isnt quite cutting it? So dont ever be afraid or reluctant to keep going back to the Doc to say you'd like to try something different. Again, its a lesson that took me 20 years to learn so if i can save you that wasted time, i hope my mistakes wont have been totallly wasted!!

You mention your sleeping - I find Mirtazipine the perfect anti-depressant for me, its very calming and brilliant for helping you sleep at lower doses. I also find it levels out my eating - my problem is erratic eating patterns and hypothyroidism causing weight gain because of the lithium i am also on - it might be worth asking your Doc to see if it'd suit you to give it a try?

sleep is really really important - i would say dont worry too much about the ins and outs of your diet, because lack of sleep can have such a major effect on your metabolism appetite etc etc that just sorting that out may really put everything back on track. I know if I get careless and start missing sleep Im guaranteed to have a manic episode, or put on a lot of weight. So a more sedating anti-depressant may be just the job to help put you back on the right road?

All the best anyway my dear - look after yourself and I find it immensely soothing to meditate on the wise words of the medieval mystic nun Julian of Norwich:

"All things will be well, and all things will be well, and all manner of things will be well"

 

You have also been mislead.  You must know what bipolarity is and that it is a condition - bipolar (manic depression) - that stays with you. Now you know that you have suffered depression all those years which can be overcome and you have benefitted from the meds. So forget about all that talk of bipolar which even to mention is not helpful. Thankfully you will make a full recovery from depression and enjoy your life.

Hi Jaguar - yes of course I know that bipolar is a permanent condition, I have Bipolar 1. However AnonymousGirl (whose discussion this is) doesnt have bipolar - she has depression.

I have depressive episodes as part of my bipolar, so I understand that part of it, and im just trying to pass on some of my experiences, having learnt a lot the hard way over the last 20-odd years, to try and save someone else wasting so much time like I did. Theres so much misinformation out there that discourages people from trying medication that I always try to give people the upside of meds, cos it pains me to think of people suffering needlessly!

Sadly i know I wil always have bipolar, but like you say, anonymousgirl has depression/anxiety, and with the right meds can get better. 

 

Thank you Christine. I think I will stay on the citalopram for the moment. I found my anxious dreams went away once I finished exams and I don't seem to be having any other side effects. I was sleeping fine until I went out two nights (no drinking) and went to bed at 6am which was totally against my sleeping pattern. Then every night I kept staying up late till about 2am. I tried to get back to the sleeping pattern I prefer which is bed half 10, up at about 8 by setting an alarm in the morning. But I couldn't sleep last night until very late, like 5 or 6am so I only woke up at 12pm. So I think the sleeping is just a matter of getting back into the rythym of things. I think I'll set an alarm now anymore for next couple of days and make a conscious effort to go to bed early. 

I went for a walk out in a really nice park today and I found I felt so tired and hungry after. But  I kind of forgot to eat more after dinner and I found I couldn't sleep just now because I was too hot and hungry. I had something to eat and delayered but I am still very anxious. Calming down a bit now I've the window open and I'm a bit distracted from my own thoughts.

I have actually decided to go back to therapy for a while as I have only had 6 weeks. It's hard to break habits that you've had for years by only retraining yourself for 6 weeks! So someone close to me suggested I go back to therapy and to be honest, that was always the original idea anyways so I'm happy enough with it.

Thanks for sharing your experience about the meds though. I was always afraid to go on meds because I was afraid I'd get addicted. But I am glad I did. 

Right now though, I think I'll try going back to therapy rather than changing meds as it was only when I left therapy that I started to go downhill and the doctor warned that meds should only be alongside therapy, not on their own which is how I've been the last couple of weeks. His take on it was that the meds, like you said, allow you to look at yourself by giving you the right brain therapy. So I want to keep looking at myself as I've realised there were some issues I didn't even get time to bring up in counselling before!!! 

The essential point here for you, Christine, is that you are not bipolar. Anyone who is bipolar does not have clinical depression as a separate condition. That is why I said you have been mislead, and that is why you have had such a change taking antidepressants for clinical depression. It is great to hear you have had such a change, and thank goodness because that would not happen if you were bipolar.

No Jaguar, Im sorry but i have a formal diagnosis of Bipolar 1. So I have manic episodes, followed by severe depressive episodes. When I have a depressive episode as part of my Bipolar, it is treated by my psychiatrist with anti-depressants alongisde Lithium and Depakote which are both the mood stabilisers that I am on permanently. Hope this explains, I know Bipolar is quite a complicated and misunderstood illness to the general public. Thats why for 20years I was diagnosed as having unipolar depression - most GPs are just as ignorant about the presentation of Bipolar 1.

The depressive episodes are very similar in quality to the Unipolar depression suffered by AnonymousGirl, hence my replies. Lets not forget that who started this discussion with an honest and brave request for help! So lets keep the discussion focussed on helping her rather than questioning my diagnosis, please? Im just trying to pass on the benefits of my experiences. 

It sounds like you have the balance right - meds to treat the brain chemistry (physical side of it), counselling to examine and get some feedback about thinking patterns, exercise to get fresh air and a change of view as well, and sleep which is so important - Im sure you are going to be fine, and i wish you well for a good recovery!!! 

I know its difficult, but do try to keep dismissing those thoughts that are self-critical (accusing yourself of being self-pitying, etc). Depression is as much a physical illness - its just that the symptoms are emotional and psychological - if it was possible to cure clinical depression (as opposed to just a bad case of the blues, which everyone gets now and then) with positive thinking or self-control, you would have done it by now with no need for a doctor!! Fact is - you wouldnt blame yourself for getting the flu or epilepsy! So be kind to yourself. Its not your fault and you sound like a really lovely person who doesnt need any 'self-improvement'!!

All the best xx

Thanks Christine. 

I would hope that I can still retrain my brain with some effort on my part without needing to stay on medication longterm. I tend to abuse different drugs/medications as I can start to convince myself I can do without them and then find myself slipping back down.  I have been on meds much longer and more constantly than therapy but it was just after I stopped therapy I started to go back down again. That is why I want to try going back to therapy for a while.I want to think, to believe, that this is not forever. I understand that life has ups and downs but I do not want to feel like I will be incapicitated by depression forever.

I wish you all the best too. Thank you for sharing your experience with me. It sounds like you have had a tough enough time. Medical professionals are not always on the ball indeed. A nurse that saw me once told the secretary to put my next appointment later in the day, even if I would miss a college lecture so that "some poor soul" could be seen first thing in the morning instead. I agree with you depression is also a physical illness. In fact the fact that it is in part self-induced makes it even worse. It really bugs me when professionals treat you like the physical symptoms aren't real or important/scary/sore/uncomfortable. 

anonymousgirl

Thanks Jaguar for your comments but please remember you told me I am never alone. Please don't make Christine feel alone. We're all here to help each other. I appreciate the help that everyone who has replied has given me as I know that each reply is a sign of support that with only the best of intentions behind it. Just as I know that your comments are too. I still feel like your advice was bang on and particularly relevant to how I was feeling and thanks for that. You were the first to comment too, just when I was depending on a quick reply which was great but I also feel like I have taken something from each comment that everyone has written. 

 

My only reason for posting here is when I feel I have some knowledge that can be of help to one or more people. I certainly have no intention of making anyone feel alone - rather the opposite. What bothers me when reading so many comments here is what appears to be a lack of knowledge, lack of understanding and most importantly a lack of relevant information - especially when that invites a range of doubts about what has been said. On top of that is the knowledge I have (and many others have too) that medics have failed the patient - in diagnosis, treatment and drugs.

Many people have had to live with incorrect diagnoses; many of those because they have not (cannot, will not) challenge the medics. The best medics will always admit that they cannot be correct all the time. Others will continue as if they are always right and should never be questioned. Fortunately the latter are being challenged more regularly but there are still a lot of problems to be resolved in the ways that many medics perform their duties. From the ways that Christine described her problems there seemed to me to be one huge question mark over her diagnosis. I considered that to be very important for her to consider.

Anything to do with our brains is still part of one huge unknown area, despite all the advances in recent decades. This is so very different to much medical practice. If you've got chicken pox the diagnosis is clear and unequivocable; we know almost everything we need to know about cancer in all its varieties except the definitive cure for everyone; we have yet to explore and understand the many mysteries within our brains. Therefore I believe that we should continue to keep an open mind about every diagnosis concerning our mental capacities and abilities.

One final point. Until we have the definitive answers no medic has one. As we are unique, everyone of us, then everying concerning each one of us may be unique or may be repeated in many others and across many differing groups in relatively small numbers or in billions. This is the continued challenge for the human race to discover, reveal and benefit from.

Jaguar, I understand where you are coming from. That is why I said that your advice was particularly relevant but believe you me, I am able to thank everyone for their advice and decide which one is relevant for myself. Just as Christine is.You gave me your advice, there is no need to chastise someone for also trying to advise me.

I understand you are angry with the medical profession. I am too. And people's ignorance when it comes to mental health issues in general. I do not care to go into my reasons why in detail but believe you me, I understand. 

As regards diseases and diagnoses and how much/little we understand, I agree with you. Except on the point that we know nearly everything about cancer. You acknowledged that there are many different forms of cancer, I agree. Some we have genetic or environmental links to, some we don't. The reason why we can't cure "it", is because it is hard to detect it early, like many different diseases. Which not only makes it hard to eradicate the cancer before it has spread too far but also makes it harder to study early disease progression which contributes to difficulty in early detection. The fact that the disease can metastasise and also, as you acknowledged interpersonal variability, makes it difficult to study the many forms of cancer that exist. 

You're strong Jaguar, I can hear you roar and I admire you for it. Too many people stay silent when they should speak up. But what one cancer patient might need to hear at one point in time is different to what another cancer patient may need to hear at the same point in time, regardless of the severity of cancer in either patient. And that comes back to the interpersonal variability that you yourself mentioned. That's all I'm trying to say.

I think we'd get along very well in person you and I, except for the fact perhaps that both of us are probably quite stubborn. I don't wish you any harm. I believe you to be intelligent, strong and with good intention. I wish you all the best. I'd like to return the favour of giving you some help/advice in return if you ever need it. Sometimes, for independent people like you and I, being able to accept help is the strongest thing we can do.  

Easy, tiger  I WAS misdiagnosed - as having unipolar depression. I have now been correctly diagnosed as haiving bipolar 1. I know this cos the combination of lithium, depakote and occasional anti-depressants I am now on WORKS.

But surely these experiences make me better able to advise - having learnt the hard way to keep going back to the doctors until the treatment is successful?

And how does that make my contribution any less valuable or relevant than your own? 

Your anger at me seems misplaced; I wonder what your experiences are that cause you to be so judgemental?

But I was not angry, at least not at you but for you. You are every bit as entitled to your comments as anyone else here including me. This is not the place to reveal just how much is wrong within the NHS, and why, and also that everything being done is making it worse. However, my personal experiences plus that of my wife and son together with decades of examples from the wider family, and not ignoring two doctors within that family, have provided more information than I wish I knew. As for the political side then words fail me.

You did, I hope, read as far as my comments on your good news and your future; make sure they monitor your lithium regularly.